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Doctors Call for HPV Vaccination of Young Gay Men

Written by Nina Lincoff
| Published on July 16, 2013

If we can prevent anal cancer by vaccinating high-risk groups, why aren’t we?

By all accounts, efforts to vaccinate young girls against the human
papillomavirus (HPV) have been a success, preventing potentially fatal
cases of cervical cancer. Anal cancer is caused by the same strains of the human papillomavirus
that can cause cervical cancer in women. But for gay men, for whom the
risk of anal cancer is higher than for heterosexual men or women, there
are still barriers in the way of access to this preventative vaccine.

Introduced
in 2006 in the U.S., two HPV vaccines, Cervarix and Gardasil, are
administered to teenage girls in three doses over the course of six
months. In the time since the vaccine was introduced, the incidence of
high-risk HPV has declined among teen girls by 56 percent, according to a
recent study published in The Journal of Infectious Diseases.

Because some anal cancer cases can also be prevented by the same vaccine, an editorial published yesterday in the British Medical Journalcalls for targeted HPV vaccinations of gay men up to 26 years old.

“Rates
of anal cancer in men who have sex with men are as high if not higher
than cervical cancer in women, but no suitable screening mechanisms
exist,” study author Mark Lawton, MD, of the Liverpool Centre for Sexual
Health in the UK told Healthline.

Because HPV is most easily
transferred through sexual contact, it's important to vaccinate young
people before they become sexually active or have had too many partners.
Currently in the U.S., Gardasil vaccinations are recommended for boys
between the ages of 11 and 21, and up to the age of 26, according to the
Centers for Disease Control and Prevention (CDC).

The
logic behind systematically vaccinating young girls is that straight
men will benefit from “herd immunity,” meaning that vaccinating half the
population should have a protective effect on the other half. But gay
men are left out in this scenario. “It is the men who have sex with men
that lose out from that plan, and thus why we are recommending targeted
vaccination,” Lawton said.

While it seems logical to offer
vaccinations to both boys and girls regardless of sexual orientation
before they have intercourse to prevent HPV from spreading at all, cost
and limited resources make this plan problematic. “It would be easier
and better to vaccinate all boys routinely as well as girls, from the
age of [11 to 12 years], as they have recently started doing in
Australia. Unfortunately, it comes down to cost and cost effectiveness,”
Lawton said.

So, researchers are recommending targeted
immunizations for high-risk groups—women because of their cervical
cancer risks and gay men because of their anal cancer risks.

Lawton
hopes his editorial will draw attention to the benefits of HPV
vaccination, increase political pressure to expand the vaccination
program, and increase public awareness about a cancer for which
preventative steps are currently not being taken.

Prejudice in the medical treatment of gay and lesbian patients has in fact been dissipating. A 2012 report from the Human Rights Campaign
found that the number of healthcare facilities deemed leaders in the
treatment of LGBT patients jumped from 71 to 212. The increase was
especially notable among hospitals serving veterans after the repeal of
"don't ask, don't tell" policies about disclosing one's sexual
orientation in the armed forces. Still, there is more to be done.

“Young
people are more open about their sexual orientation these days and may
well be willing to disclose at a younger age if they were aware of an
advantage such as accessing HPV vaccination,” Lawton said.

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